International Perspectives in Prostate Cancer: A Look at Treatment in India

In a special episode of Oncology Decoded, hosts Manojkumar Bupathi, MD, MS, and Benjamin Garmezy, MD, spoke with their colleague Debapriya Mondal, MBBS, MD, DrNB, who connected to the conversation from India. Collectively, the trio reviewed how clinical practice may differ in US- and India-based institutions, specifically as it relates to the treatment of patients with prostate cancer.

According to Mondal, while prostate cancer does not represent one of the top 5 most diagnosed cancer types in India overall, patients appear to present with disease more often in cities like New Delhi, Kolkata, and Bangalore. Additionally, many patients in India appear to be diagnosed with more advanced stages of disease compared with reports in the US.

Regarding medical practices in the US and India, the group discussed potential differences in treatment pathways and specialties that are initially involved in care. Additionally, they highlighted how urologists decide on sequencing androgen deprivation therapy, androgen receptor pathway inhibitors, and other modalities based on region-specific considerations.

The conversation also touched upon the costs of various therapies between regions, as Mondal outlined how patients in India may have access to cheaper generic products for reference drugs like olaparib (Lynparza) and rucaparib (Rubraca). Despite other differences in terms of insurance coverage and barriers to treatment access between regions, the group noted certain international similarities in their respective treatment models, including strategies for the management of advanced or localized disease.

Bupathi is the executive cochair of the Genitourinary Cancer Research Executive Committee at Sarah Cannon Research Institute (SCRI) and a medical oncologist with Rocky Mountain Cancer Centers, specializing in solid tumors and genitourinary cancers. Garmezy is the associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at SCRI and a medical oncologist at SCRI Oncology Partners, specializing in genitourinary cancers. Mondal is a consultant medical oncologist from Foris Healthcare in Kolkata, West Bengal, India.